Abstract
Over 20 years, hospitals in Italy as well as in other European countries have evolved and changed in response to institutional pressures. With the corporatization, there has been the entrance of new logics and governance structures that contributed to a transformation of the health system. The survival of healthcare organizations is dictated not only by the technical conditions, that allow efficiently and effectively operating, but also by the ability to comply with rules to get legitimacy from external institutional actors. Organizations in a population adapt to their environment, in which operate, so many other organizations adapting to it (isomorphism). The purpose of this paper is to discuss a theoretical framework based on neo-institutional approach that could explain the influence of isomorphic pressures on innovative processes in health care sector. Qualitative data from literature on neo-institutional theory applied to health care sector have been analyzed. Findings reveal institutional pressures stimulate the development of innovations and organizational learning. This concept concerns both the fit of the organization with its environment (strategic matters) and effective implementation of strategies. Hospitals must find ways to increase profit, by improving medical capabilities for payment health care services. One of the most important isomorphic pressure is the prospective payment system for health care that had effects on the choices of organizational models to adopt. The challenge for hospital administrators is to seek consistency between efficiency and quality care.
Highlights
In all countries with advanced welfare systems, healthcare organizations operate in complex institutional systems, which define their space of autonomy in relation to health policy choices and affect their strategic choices, organizational design and management (De Simone, 2011a).Over 20 years, hospitals in Italy as well as in other European countries have evolved and changed in response to institutional pressures
There has been the entrance of new logics and governance structures that contributed to a transformation of the health system
The purpose of this paper is to discuss a theoretical framework based on neo-institutional approach that could explain the influence of isomorphic pressures on innovative processes in health care sector
Summary
In all countries with advanced welfare systems, healthcare organizations operate in complex institutional systems, which define their space of autonomy in relation to health policy choices and affect their strategic choices, organizational design and management (De Simone, 2011a). The institutional approach focuses on social processes of construction of reality, and how the existence of social interactions tends to stabilize reality through processes of legitimation and to define constraints on the range of possible actions, reducing the variability and unpredictability of individual behavior (De Simone, 2011b). This means considering the organization not as the product of the rational design, but as the result of institutional adaptation to the environment. The national health fund was distributed to hospitals according to the spending of the previous year; nowadays hospitals receive a fixed amount based on diagnosis related group for each discharge (De Simone & Siani, 2015)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
